Hospice by the Bay celebrates 35 years of care

HEALTH Hospice by the Bay pioneered services for terminally ill, family

Published 4:00 am, Monday, August 2, 2010

Photo: Liz Hafalia, The Chronicle

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Hospice worker John Babbos (middle) plays with Jesus Pineda (left), as he gets him to smile at home in San Francisco, Calif., on Monday, July 19, 2010. His wife Alicia Pineda says Babbos has been a great help, and is able to run errands and grocery shop while Jesus is being watched. It is the 35th anniversary of Bay Area Hospice, the oldest hospice provider in the state. less

Hospice worker John Babbos (middle) plays with Jesus Pineda (left), as he gets him to smile at home in San Francisco, Calif., on Monday, July 19, 2010. His wife Alicia Pineda says Babbos has been a great help, ... more

Photo: Liz Hafalia, The Chronicle

Hospice by the Bay celebrates 35 years of care

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His world now is a small bedroom in the family's home in the Excelsior district, a room with soft light, framed photos and meaningful relics - saints and crosses - and a carefully archived collection of taped nature shows.

Sitting on a worn chair next to the bed and in front of the TV, Jesus Pineda manages a gentle smile when a volunteer from Hospice by the Bay arrives for a weekly visit. Pineda, who is 84, has pulmonary fibrosis, a terminal lung disease.

The volunteer, John Babus, who is retired, will spend several hours at the Pineda home, providing company for the patient and respite for the caregiver - wife Alicia Pineda.

"They are very nice people and provide a lot of help," Alicia Pineda said of Hospice by the Bay. "When you need it, they send you a nurse, a chaplain, someone to give a bath, even a massage therapist. And having a volunteer here gives me time to go to the store, or just be at home and not worry."

Hospice by the Bay, the oldest hospice in California and the second oldest in the nation (the first was in Connecticut), is celebrating its 35th anniversary. Founded as Hospice of Marin in 1975 to care for dying patients and their families, Hospice by the Bay now serves about 320 patients every day - in their homes, hospitals, residential hotels or care facilities.

Mary Taverna, a nurse and founding member of Hospice of Marin, said the movement began because there was a void in services for the terminally ill.

"This was in the mid-'70s, and health care was delivered in a certain way," said Taverna, who served as Hospice's CEO for three decades. "The focus was on physical needs, on disease and symptoms. We wanted to provide for physical needs, but also provide benefits that were psychological, social, emotional and practical. We saw this as the last gift you can give to a person."

The movement was enabled and validated in August 1982, when Congress approved legislation authorizing Medicare coverage of hospice services.

"When hospice started," Taverna said, "it had no reimbursement tied to it. But it became clear that this was the type of health care people wanted."

Hospice by the Bay serves end-of-life patients in Sonoma, Marin, San Francisco and San Mateo counties. Qualifying for hospice requires a physician's order indicating the patient has a life expectancy of six months or less.

Sandra Lew, Hospice by the Bay's current CEO, said, "Watching a loved one deteriorate and die is the hardest experience in life. That's why this whole program was created. Individuals and families should have the support of a team of people to get through it. Our services are about living. If your life is reduced to four walls, you can make the best of it."

At the home of Jesus and Alicia Pineda, life is defined by waiting and watching, by monitoring pain and easing fears.

The couple, who met in Mexico, have lived in their Excelsior district home for almost 35 years. "Somehow, we made it through all of the ups and downs," 78-year-old Alicia Pineda marveled.

"I don't want to die and leave her alone," Jesus "Jessie" Pineda said of his wife, his eyes suddenly welling with tears. Alicia shook her head no. She told him that she would not be alone: She has her son, their home, friends, and relatives. And, she has their memories.

Jesus Pineda looked around the room. His eyes lit up when he landed on an arm-length metal hook, which he pulled from a bookshelf down to his lap. He had used it for nearly 40 years in his job at Foremost Dairies in San Francisco, relying on the hook to pull heavy milk cases.

"He wants the hook in the box," cracked his wife, adding, "in his casket."

He nodded, adding that he also wants a picture of Alicia and his relic of St. Jude - the patron saint of hopeless or lost causes - in his box.

John Babus, the volunteer, was one of several hospice providers to visit the house during a recent week. A registered nurse came to check on Pineda's left eye, which had turned a deep red, and a health care worker was there for his regular baths. Volunteers to hospice must undergo a series of training sessions that cover a wide range of topics, from dealing with dementia to the physiology of dying.

Babus says his visits are easy: The two men talk when Jesus Pineda feels like talking, or they sit and watch nature shows. Pineda is drawn to animal and nature shows, he said, because "animals behave so much better than people."

Babus, whose sister received hospice care before dying of pancreatic cancer, said he does whatever is needed in a house, whether helping with cleaning, feeding or getting someone to the bathroom. He is one of more than 550 volunteers dedicating time to Hospice by the Bay.

"The dying process is a quiet thing," Babus said. "My time with hospice has taught me not to be afraid of dying. I have learned grace and acceptance. And it's made me more grateful for every day."

Jesus Pineda, seated in his worn chair, oxygen tubes helping him breathe, said life is not for the meek. And while he can no longer make his famous tamales or defeat his friends in a game of pool, he hasn't given up.

"The muscles are not good," he said, gesturing to his narrow frame shrouded by the wool blanket. But pointing to his head, he said, "This one is still good."

For information on Hospice by the Bay, go to www.hbtb.org or call (415) 927-2273.

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